The Mississippi State University College of Veterinary Medicine Shelter Surgery Program

by Philip A. Bushby, DVM, MS, DACVS and Kimberly Woodruff, DVM

March 25, 2013

Mississippi State University's two mobile spay/neuter units.
Dr. Phil Bushby

Learning surgical skills is one of the expected outcomes of a veterinary education. Typically, students develop basic surgical psychomotor skills in surgery laboratories, but may not have significant opportunities to refine those skills during the veterinary curriculum. As referral level patients have become the predominant percentage of surgical caseloads in veterinary teaching hospitals, students often are relegated to the roles of assistant or observer in most clinical surgeries. In an effort to overcome the paucity of routine surgical cases in many university teaching hospitals, many schools have developed relationships with animal shelters to provide students increased opportunity to practice surgical skills.

Shelter Partnerships Provide Surgical Training Opportunities

In the early 1990s, the College of Veterinary Medicine at Mississippi State University initiated a program with a nearby animal shelter to give students additional surgical experience. The program was focused on spay/neuter surgeries and involved only one shelter -- one with a surgical suite in its facility. Every junior veterinary student would spend one day at the shelter performing spays and neuters under faculty supervision. In 2005, with the construction of a new shelter in Starkville, Miss., the College's shelter program was expanded to include two shelters, and every junior student spent two days performing spays and neuters.

All that changed after Hurricane Katrina. In the aftermath of the storm, the College received major support to greatly expand its shelter program. A grant from the American Kennel Club Companion Animal Recovery division helped the College purchase a mobile veterinary unit equipped for emergency response and spay/neuter. A significant grant from The Humane Society of the United States provided funding to increase the number of shelters visited and the numbers of surgeries performed.

In 2007, the shelter program acquired a Mobile Veterinary Unit, a fully equipped 32-foot gooseneck trailer. With that unit, the shelter program grew to a point where,we now provide spay/neuter and basic wellness services to 15 different animal shelters in north Mississippi. The unit is taken to shelters four days a week with an average 30 spay/neuter surgeries performed each day. Since 2007, the program has been responsible for more than 32,000 sterilization surgeries.

The team that goes out on each trip generally consists of three students, one technician and either one resident and a faculty member, or one faculty member.

Students Develop and Refine Skills with Shelter Rotations

Students are involved in this activity in two ways. Our curriculum is structured with third-year veterinary students having nine months of required clinical rotations on a staggered schedule and fourth-year veterinary students having four months of required clinical rotations and eight months of elective options. Every third-year student, while in our Community Veterinary Services (routine small animal) rotation, spends two days on the unit. In those two days, the third-year students average a total of 15 spay/neuter surgeries. Either a faculty member or resident scrubs in as an assistant every time a third-year student performs surgery. The students perform the surgeries, but the assistant guides them, prevents them from making serious mistakes, gives them immediate verbal and then written feedback on performance, and helps them out if they have problems.

Fourth-year veterinary students can enroll in a two-week Shelter Medicine Spay/Neuter Rotation elective. Two students are takenat a time for two week spans, and the elective runs 50 weeks of the year. An assistant scrubs in with fourth-year students on the first day of the elective; after that, the students perform the surgeries by themselves unless they have problems and request help. In each two-week rotation, fourth-year students will generally visit seven or eight different shelters and, on average, perform between 75 and 80 surgeries. One current senior student performed 128 surgeries in two weeks: 126 sterilization surgeries, an enucleation, and a cystotomy for removal of cystic calculi.

Taking two seniors at a time for two week spans during 50 weeks of the year results in a maximum capacity of 50 senior students each year. However, the college admits 85 students per class. Because of the extensive surgical experience obtained, the demand for the elective rotation is much greater than 50 per year, so enrollment has been determined by a lottery.

Each year, first-year veterinary students receive a lecture on pet overpopulation and what can be done about it. Spay/neuter is discussed, as is our shelter program. During the lecture in 2011, when the students in the Class of 2014 realized that the maximum capacity in the elective was 50 and that 40 percent of the class would not be able to take the elective, the class initiated a project to raise funds to purchase a second mobile unit. In six months, the students raised $56,000 and then acquired a grant from PetSmart Charities allowing the acquisition of another mobile unit. Having the second mobile unit significantly increases the number of shelters we service, the frequency by which we go to each shelter, the number of animals we can care for, and the number of students that can be enrolled in the elective. Not only will every fourth-year MSU-CVM student be able to take the elective, but we will also be able to take up to 40 students from other schools as externs each year.

Benefits for Students, Community, and the Animals

With the exception of faculty salaries, the entire spay/neuter program is funded by grants and donations. While funding sometimes gets tight, the upside of this method of funding is that we can provide our services to animal shelters at no cost. The majority of the shelters we service could not afford to pay even a nominal fee.

In addition to providing services to shelters, we conduct Community Spay Day events approximately 12 times a year. These events allow low-income families to have their pets spayed or neutered for free. Local humane groups generally organize the events and screen potential clients to make sure they are eligible for free services.

The shelter program is extremely popular. Most students enroll not because they are interested in shelter medicine or careers in high volume spay/neuter, but because it gives them extensive surgical experience. And surgical skills transfer from one procedure to the next, and from one species to another. Obviously, the program is very popular with the shelters because they receive these services at no cost. Many of the shelters we service have a 70 percent or greater euthanasia rate, but a greater than an 80 percent adoption rate of the animals we sterilize. Approximately 53 percent of our surgeries are on animals five-months-old or younger.

For the most part, practicing veterinarians are supportive of our efforts. They have come to understand that the patients we work on are not their patients and, in fact, we take some pressure off them to provide reduced-cost services to animal shelters or low-income families.

Most veterinary schools teach students how to perform spays and neuters at a point in the students' education when they are very inexperienced surgeons. Students are therefore taught many techniques that are simply designed to compensate for lack of surgical skills. Students are taught to double-ligate everything because instructors don't trust their ligatures. They are taught interrupted patterns because instructors don't trust their knots. They are taught long incisions and extensive exposure because instructors believe students don't fully understand abdominal anatomy. Unfortunately, in many curricula there are limited opportunities to refine surgical techniques as students become more comfortable and more skilled. The MSU-CVM shelter program provides the opportunities for refinement of surgical skills, and students become comfortable and skilled at using the highly-effective and efficient techniques used in high volume spay/neuter clinics.

Update: April 29, 2013

Since publication of this article, Mississippi State University CVM's shelter surgery program has expanded to serve 18 different shelters/humane groups and has now completed more than 35,000 surgeries. 

Philip A. Bushby, DVM, MS, DACVS

Dr. Bushby is a 1972 graduate of the University of Illinois College of Veterinary Medicine.

Dr. Bushby is a Board Certified Veterinary Surgeon and currently holds the Marcia Lane Endowed Chair of Humane Ethics and Animal Welfare at Mississippi State University where he has been on the faculty for 35 years.

His primary focus is spay/neuter, and the shelter medicine program he supervises brings junior and senior veterinary students to animal shelters in north Mississippi to provide basic wellness care and spay/neuter services for animals eligible for adoption. The program significantly increases the adoption rates of the participating shelters, provides the students with an exceptional surgery experience and sensitizes the students to the plight of animals in shelters. His program was honored just last year as a featured display in the Smithsonian Institutes folk-life festival in Washington DC.

Dr. Bushby's interest in shelter medicine and spay neuter dates back to his internship and surgical residency at the Henry Bergh Memorial Hospital of the ASPCA in New York City. He states that his primary goal is to make sure that the next generation of veterinarians understands the problem of overpopulation of unwanted dogs and cats and recognizes their role in assisting in addressing this problem.

Dr. Bushby serves on the Board of PetSmart Charities, Inc., Mississippi Spay and Neuter and the Association of Shelter Veterinarians. He is a member of the organizing committee that is currently developing the proposal for a specialty board in shelter medicine and received the AVMA's national Animal Welfare Award in 2012.

Kimberly Woodruff, DVM

Dr. Woodruff is a 2008 graduate of the Mississippi State University College of Veterinary Medicine. She served as a shelter medicine intern at MSU-CVM from 2008-2009 and is currently a an assistant professor at MSU-CVM. Dr. Woodruff is an expert in shelter medicine, spay/neuter, and disease control, and has a special interest in epidemiology.